| NPI | 1588629844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 014349) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: NY 014349) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |